Impact of Arab Accreditation Project on Patient Safety Arab Hospital Federation Congress Sharm El Sheikh-Egypt 4-5 March

1. Impact of Arab Accreditation Project on Patient SafetyArab Hospital Federation CongressSharm El Sheikh-Egypt4-5 March,2008 Dr.Safa El Qsoos/Quality Director Ministry of health/Jordan

2. Accreditation • Process in which an entity, separate and distinct from the health care organization, assesses the health care organization to determine if it meets set of requirements designed to improved the quality of care, its usually voluntary and provides a visible committement to improve quality of patient care, ensure a safe environment, and continually work to reduce risks to patients and staff

3. Accreditation history • 1910 Ernest Codman, M.D., proposes the “end result system of hospital standardization.”  Under this system, a hospital would track every patient it treated long enough to determine whether the treatment was effective.  If the treatment was not effective, the hospital would then attempt to determine why, so that similar cases could be treated successfully in the future.

4. 1913 • American College of Surgeons (ACS) is founded at the urging of Franklin Martin, M.D., a colleague of Dr. Codman. The “end result” system becomes an ACS stated objective.

5. 1917 The ACS develops the Minimum Standard for Hospitals. Requirements fill one page. • 1918 The ACS begins on-site inspections of hospitals. Only 89 of 692 hospitals surveyed meet the requirements

6. 1926 The first standards manual is printed consisting of 18 pages. • 1950 The standard of care improves over time and more than 3,200 hospitals achieve approval under the program

7. 1951 The American College of Physicians (ACP), the American Hospital Association (AHA), the American Medical Association (AMA), and the Canadian Medical Association (CMA) join with the ACS to create the Joint Commission on Accreditation of Hospitals (JCAH), an independent, not-for-profit organization whose primary purpose is to provide voluntary accreditation.

8. 1953 JCAH publishes Standards for Hospital Accreditation. • 1970 Standards are recast to represent optimal achievable levels of quality, instead of minimum essential levels of quality. • Accreditation for hospitals and long term care facilities is reduced to a maximum of two years from three years. Where survey findings indicated that necessary improvements had not been made or completed, accreditation is given for one year. 

9. 1987 The organization name changes to the Joint Commission on Accreditation of Healthcare Organizations to reflect an expanded scope of activities. • The Agenda for Change is launched with a set of initiatives designed to place the primary emphasis of the accreditation process on actual organization performance.

10. 1992 The Accreditation Manual for Hospitals begins the multiyear transition to standards that emphasize performance improvement concepts.

11. 1996 The Sentinel Event Policy is established for the evaluation of sentinel events in accredited organizations and their relationship to accreditation status. 

12. IOM Report /1999 To Err Is Human: Building a Safer Health care System 98,000 preventable deaths each year,with an associated cost of $17 to $29 billion.

13. 1999 • The Joint Commission’s mission statement is revised to explicitly reference patient safety: "The mission of the Joint Commission is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations

14. 2001 • The Joint Commission forms a 20-member Standards Review Task Force to identify the accreditation standards most relevant to the safety and quality of patient care, and target for elimination or modification those standards that do not contribute to good patient outcomes. • New standards that focus directly on patient safety and medical/health care error reduction in hospitalstake effect July 1. 

15. 2002 • The Joint Commission establishes its first annual National Patient Safety Goals and associated requirements for improving the safety of patient care in health care organizations, to be effective in 2003. • Joint Commission President Dennis S. O’Leary, M.D., testifies before the House Committee on Energy and Commerce, Subcommittee on Health, on private sector efforts to improve patient safety  

16. 2003 • The Joint Commission announces a Universal Protocol™ for preventing wrong site, wrong procedure, wrong person surgery, effective July 1, 2004.  • The Joint Commission forms a 20-member expert panel to consider and recommend ways in which the Joint Commission’s infection control standards can be strengthened. Later in the year, the panel approves revised standards that sharpen and raise the expectations of organization leadership and of the infection control program itself.

17. 2004 • The World Health Organization launches its World Alliance for Patient Safety in October, and the Joint Commission is invited to be involved in several of the Alliance’s initiatives.

18. 2005 • Joint Commission President Dennis S. O’Leary, M.D., testifies before Congressional leaders in June that American health care facilities must embrace a “systems approach” to preventing adverse events that keeps the errors that caregivers inevitably make from reaching patients.

19. 2005 • The World Health Organization in August designates the Joint Commission and Joint Commission International as the WHO Collaborating Centre for Patient Safety Solutions.

20. 2006 • The World Health Organization Collaborating Centre on Patient Safety, the World Alliance for Patient Safety and the Commonwealth Fund announces a seven-country collaborative project in December that will leverage the implementation of five standardized patient safety solutions to prevent avoidable catastrophic events in hospitals.

21. 2006 JCI introduced the IPSGs in 2006 and surveyors have been evaluating compliance with these goals during accreditation surveys in 2006, but these findings have not affected the accreditation decision. Beginning 1 January 2007, hospitals accredited by JCI are required to display compliance with the following ISPGs (in addition to JCI’s 368 standards in 11 chapters): Goal: Identify Patients Correctly.Goal:Improve Effective CommunicationGoal: Improve the Safety of High-alert MedicationsGoal: Eliminate Wrong-site, Wrong-patient, Wrong-procedure Surgery.Goal: Reduce the Risk of Health Care–acquired InfectionsGoal: Reduce the Risk of Patient Harm Resulting from Falls

22. JoshuaGoldberg1982-2006Death of 23 year old sonThis is a living case history concerning the death of my 23 year old son who died at Bumrungrad Hospital in Bangkok Thailand on 23 February 2006 at approximately 9:00 PM, Thai time Yes, this is a case about the death of a human being at the hands of malicious people. But it is also a case which illustrates that money and power drives medical care in the US and, by extension, internationally.The last concern of thismachineis your health, care and safety.

23. Bumrungrad, the hospital where my son was murdered, is accredited by the Joint Commission.  Yet, despite having informed them, time and again, of factual wrong doing, they have remained silent and have denied that they have any responsibility to the public reveal the Accreditation: Once Given, Never Revoked

24. Patient for patient safety Movement Leaded by Susan Sheridan Lost her husband because of the health care provided in accredited hospital,and her son is suffering of permanent disability patient safety awareness week March 2nd- 2th. 2008

25. In the Arab countries ? • Research in 2005 on the size of harm to patient WHO/EMRO,Dr.AHMAD ABDULATIF Australian Research Center Dr.Ross Wilson

26. The Arab Accreditation Project Introduction on Why the project focus on patient safety Standards relevant to patient safety • أ. معايير رعاية المريض • ب. معايير أمان وسلامة المريض • ج. معايير الإدارة • د. معايير الخدمات المجتمعية Classification and scoring high lighting standard on patient safety

27. رابعا : مستويات التطابق • المستوى المبدئي : • 75% تطابق مع معيار A • 50% تطابق من معيار B • %85 تطابق مع معايير آمان المريض

28. مستوى الاعتماد : • 85% تطابق من معيار A • 75% تطابق من معيار B • 95% تطابق مع معايير آمان المريض